Patients’ perspectives on three-monthly administration of antipsychotic treatment with paliperidone palmitate – a qualitative interview study

Abstract

Introduction: Three-monthly dosage of paliperidone palmitate entails longer time to relapse after discontinuation, is similarly tolerable and safe compared to monthly injections of paliperidone palmitate and is beneficial for the caregivers. However, few studies have so far explored in depth the patients' experiences with paliperidone palmitate medication every three months, or with switching from monthly to three-monthly injections of paliperidone palmitate. Material and methods: A qualitative study based on individual interviews with persons with schizophrenia who receive three-monthly paliperidone palmitate in Norway, Sweden and Denmark. Data was analysed according to qualitative content analysis. Results: Twenty-four patients, 16 men and 8 women, took part in individual interviews. The patients' mental health care professionals mainly recommended the switch to three-monthly paliperidone palmitate, and few or no disadvantages were described. According to the patients, three-monthly paliperidone palmitate had several advantages, such as less frequent injections, less administration and planning and less focus on the illness. In addition, the participants described feeling more stability, being more physically and socially active, and that improvement processes were supported. For some, the use involved practical and economic challenges, and some worried whether the medicine 'wore off' before the next injection. According to the patients, switching to three-monthly paliperidone palmitate did not influence the frequency or content of patients' interaction with health care professionals. Conclusion: Switching from monthly to three-monthly injections with paliperidone palmitate seems to be experienced as advantageous for patients with schizophrenia.

One-Month versus Three-Month Formulation of Paliperidone Palmitate Treatment in Psychotic Disorders: Patients’, Relatives’, and Mental Health Professionals’ Perspectives

“…Previous studies found either that the transition from PP1M to PP3M was associated with a decline in outpatient and pharmacy visits 24 or that contact frequency was not influenced by PP3M. 18 Our results suggest that this may be individually determined, essentially supporting both findings, with approximately half of our participants reporting an unchanged number of contact moments (53%) and the other half reporting a reduced number of contact moments (42%). Although our participants did not specify the reasons for any of their visits, it is likely that at least the visits exclusively intended for PP3M injections (four times a year) were less frequent compared to PP1M (twelve times a year).…”

“… 17 From a patient’s perspective, individual depth-interviews with 24 patients with schizophrenia revealed that they had more feelings of stability and were more physically and socially active after they received PP3M. 18 The authors concluded that switching from PP1M to PP3M seemed to be experienced as advantageous for patients with psychotic disorders.…”